Posted By Bob Shillabeer Hi All, Can anyone give some info on the use of Epi-pens by first aiders? An employee has suggested we train first aiders in their use and then provide them as part of our first aid boxes. I know there is no legal requirement to doso but am unwilling to dismiss simply on the law. My specific question is has anyone gone down this road and what types of Epi pen have they introduced and what are the benefits? Thanks Bob.

Posted By Alan Hoskins Hi Bob, I hadn't come accross these before, but on reading the website it seems to me that any person who knows they may be at risk from AS should carry one on their person, rather than making them available in First Aid boxes. There appear to be serious side effects if used incorrectly. Your First Aiders could still be be trained in their use though. This is purely a personal view, as I have no medical expertise whatsoever. Alan

Posted By Bob Shillabeer Just spoken to our healthcare provider and was told that Epi-pens are only available on prescription in the UK and are self administered. We have therefore decided not to go down that avenue. Thanks for the responses, very helpful. Bob.

Posted By Steve Derby This is correct Jay I both carry an epipen and am a member of a leading first aid organisation. We (ie those in our unit) have been trained to actually administer the epipen in the circumstances you describe - that it must be the pen prescribed specifically to the caualty concerned Steve

Posted By Ian P This was very interesting to me because I was recently told that some of our offices get training on how to use epi pens. For a start we don't have any insurance for this and my insurance head says that it should be stopped unless we are willing to pay medical insurance. My H&S head says that it needs a risk assessment, can anybody point me in the direction of an epi pen RA?

Posted By Ken Taylor Ian, one of our schools said that they wanted a risk assessment on epipens before using them - so I did one. Nothing wonderful, of course, but you can have a look if you let me have your e-mail address. As to the insurers, would they rather be hearing of a dead person than letting a trained person hit someone's thigh with something like the end of a pen in order to save their life. First-aiders could do far more complicated things than this. We had no problem or additional premium with our insurers.

Posted By Ian P Many thanks Ken. I'm sure insurers would not prefer a dead body but I know from the one that we use for our liabilities that they do not provide medical cover.

Posted By Jay Joshi So, what do you do in case the casualty is unconcious in a workplace scenario, has an epi-pen on them,is known to have an allergy, and has the symptoms and ? The HSE website states that:- "Therefore, first aiders may administer an Epipen if they are dealing with a life threatening emergency in a casualty who has been prescribed and is in possession of an Epipen and where the first aider is trained to use it" There is no mention of the state of consciousness. Therefore, in a workplace situation, this would should generally be covered by the Employers Liability Insurance, provided the first aider is trained an the victim is an employee.

Posted By Sean Fraser I've continued to watch this with interest and there is a strong argument being made for administering this type of treatment. However, I come back to the point of what you were trained to do, and how that affects potential liability should it go pear-shaped. There is a difference between unconscious and arrest. In unconsciousness, the casualty is still able to maintain their core functions (respiration and circulation). They are put into the recovery position and close observation maintained. In arrest, without immediate external assistance, the casualty will expire. The reason for making this differentiation is because of "implied consent". In arrest, the casualty WILL die if nothing is done, and it is therefore assumed that if they could give consent they would, regardless of any consequential injury e.g. fractured rib. This is accepted in law. The same may not be said for unconsciousness - although any sane person would say that if they fell unconscious due to anaphylactic shock that would want someone, anyone, to do all they can to assist. Mind you, the same could be said of emergency medical providers and it can be surprising how many people suddenly change their minds AFTER an event and decide that they were treated without their consent - in effect, assault. Compensation claim pending . . . So, even if you have been trained by a recognised and competent authority, you are still at risk of a claim IF you treated a casualty with any form of drug AND there was some consequential damage as a result. That is even with the "I only did what I was trained to do" defence. There is little we can do to cause more harm in First Aid, although there is plenty of harm we can cause by not doing something. So far no one has managed a successful claim because of that. But administer a drug of any sort, including oxygen, and it is a new ball game. It may be that with an increase in potential casualties, and the fact that O2 therapy is already allowed with the additional training, then it may change. But as it stands, if I had a casualty who had lapsed into unconsciousness then I would follow my training. Intervention only in the case of arrest.

Posted By Jay Joshi There is legal exemption for parenteral (administered by means other than through the alimentary tract as by intramuscular or intravenous injection) administration in an emergency to human beings of certain prescription only medicines via Regulation 7 of the The Prescription Only Medicines (Human Use) Order 1997 It includes Adrenaline Injection 1 in 1000 (1 mg in 1 ml). Refer to:- http://www.opsi.gov.uk/si/si1997/71830--b.htm#7 http://www.opsi.gov.uk/si/si1997/19971830.htm It is clear in law that the medicines legislation permits the administration in an emergency to human beings of certain prescription only medicines via Regulation 7 of the The Prescription Only Medicines (Human Use) Order 1997

Posted By Bob Shillabeer Hi everyone Well I didn't think this topic would result in such a response, thanks everyone. As I said earlier this week I spoke to our health care provider and they basically said don't do it, but there seems to be quite a diversity of opinion. We are not going down the road of training first aider in the use of epipens (following our helath care providers advise) however we are going to inform employees that if any of them use epipens they need to declare this to thier line manager who will then establish personal plans to ensure that if required proper treatment can be obtained very quickly.